Gut Liver.  2016 Jan;10(1):27-36. 10.5009/gnl15114.

Drug-Induced Liver Injury: Pattern Recognition and Future Directions

• Haque T
• Sasatomi E
• Hayashi PH

• KMID: 2382340
• DOI: http://doi.org/10.5009/gnl15114

Abstract

Drug-induced liver injury (DILI) remains a significant clinical challenge and is the leading cause of acute liver failure in most countries. An aging population that uses more medications, a constant influx of newly developed drugs and a growing risk from unfamiliar herbal and dietary supplements will make DILI an increasing part of clinical practice. Currently, the most effective strategy for disease management is rapid identification, withholding the inciting agents, supportive care and having a firm understanding of the expected natural history. There are resources available to aid the clinician, including a new online "textbook" as well as causality assessment tools, but a heightened awareness of risk and the disease's varying phenotypes and good history-taking remain cornerstones to diagnosis. Looking ahead, growing registries of cases, pharmacoepidemiology studies and translational research into the mechanisms of injury may produce better diagnostic tools, markers for risk and disease, and prevention and therapeutics.

Keyword

Drug induced liver injury; Hepatotoxicity; Diagnosis; Epidemiology; Herbal and dietary supplements

MeSH Terms

Age Factors
Anti-Infective Agents/adverse effects
Anti-Inflammatory Agents, Non-Steroidal/adverse effects
Anticonvulsants/adverse effects
Biopsy
Dietary Supplements/adverse effects
Drug-Induced Liver Injury/*diagnosis/epidemiology
Drugs, Chinese Herbal/adverse effects
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
Incidence
Liver/pathology
Liver Function Tests
Risk Factors
Tumor Necrosis Factor-alpha/antagonists & inhibitors
Anti-Infective Agents
Anti-Inflammatory Agents, Non-Steroidal
Anticonvulsants
Drugs, Chinese Herbal
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Tumor Necrosis Factor-alpha